FUSION-IENA-Study - Value of additional I-124-PET/US in comparision to conventional thyroid diagnostics alone: Results of Data Acquisition during the 2017 DGN annual meeting in Dresden

Ziel/Aim During the 2017 DGN annual meeting, multiple observers rated different patient case files (PCF) regarding thyroid diagnostics. This poster summarizes the results of the observers’ ratings. The value of additional I-124 positron emission tomography (PET)/ultrasound (US) fusion imaging in comparison to conventional diagnostics (CD) of thyroid nodules (TN) is evaluated.

Methodik/Methods Data of 34 patients were used to create a total 68 PCF, corresponding to 2 PCF per patient. One PCF comprised CD only (US video loops, scintigraphy, laboratory results, patient data) and the other PCF showed CD and additional PET/US video loops. 106 observers rated at least 4 randomly assigned PCF (none of the same patient) during the annual meeting with regard to thyroid nodule (TN) function, their confidence in functional assessment and their suggestion of treatment.

Ergebnisse/Results A total of 66 TN  ≥ 1cm ( = 1.94 TN/patient) were evaluated. A total of 748 (11.2 / TN), and 751 ratings (11.4 / TN) were recorded for CD only, and CD + PET/US, respectively. The functional assessment revealed more hyper- or hypofunctioning (524 vs. 320, p < 0.0001) and less indifferent or not rateable (209 vs. 428, p < 0.0001) TN in CD + PET/US vs. CD only. The observers’ confidence in functional assessment was superior in CD + PET/US (p < 0.0001). Furthermore, the ratings were carried out more homogeneous in CD + PET/US (p < 0.0001). Fewer suggestion of follow up (p < 0.0001), and more (p < 0.0001) suggestion of invasive treatments (fine-needle aspiration & surgery) was observed in CD + PET/US. Radioiodine therapy was more often (p = 0.0036), and thyroid medication less often (p = 0.0167) advised in CD + PET/US.

Schlussfolgerungen/Conclusions Functional assessment of equivocal TN shows frequent failures in CD, underestimating the incidence of hyper- and hypofunctioning lesions. Confidence in functional assessment significantly increases with additional PET/US.